To compare and correlate cardiovascular risk (CVR) factors through ultrasound findings, clinical, and laboratory variables.
Methods
37 patients underwent ultrasound assessment, with CVR clinical scores applied: Framingham and QRISK-3 (Risk for Increased Cardiovascular Disease in SLE). The SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) assessed systemic lupus erythematosus (SLE) activity.
Results
Statistically significant correlations were observed between the Framingham score, QRISK-3, and carotid artery diameter, with QIMT RF and expected values. Correlation coefficients ranged from 0.45 to 0.84, and p-values from 0.01 to <0.01. In linear regression analysis, variables influencing expected QIMT included QRISK-3, age, statin use, and diabetes mellitus, with p-values from 0.034 to <0.001. For QIMT RF, age and the Framingham score showed influence, with p-values from 0.028 to 0.004. SLEDAI did not significantly impact ultrasonographic parameters.
Conclusion
Carotid ultrasound was associated with in the subclinical detection of CVR in this cohort, providing complementary data to clinical evaluations.
MonticieloOABrenolJCT. Lúpus eritematoso sistêmico 1: classificação e epidemiologia do lúpus eritematoso sistêmico. In: XimenesACCecinHA (eds). Tratado Brasileiro de Reumatologia. São Paulo: Atheneu, 2015, pp. 535–546.
2.
CerveraRFontJParéC, et al.Cardiac disease in systemic lupus erythematosus: prospective study of 70 patients. Ann Rheum Dis1992; 51(2): 156–159.
3.
NihoyannopoulosPGomezPMJoshiJ, et al.Cardiac abnormalities in systemic lupus erythematosus. Association with raised anticardiolipin antibodies. Circulation1990; 82(2): 369–375.
4.
LeungWHWongKLLauCP, et al.Association between antiphospholipid antibodies and cardiac abnormalities in patients with systemic lupus erythematosus. Am J Med1990; 89(4): 411–419.
5.
BidaniAKRobertsJLSchwartzMM, et al.Immunopathology of cardiac lesions in fatal systemic lupus erythematosus. Am J Med1980; 69(6): 849–858.
6.
DohertyNESiegelRJ. Cardiovascular manifestations of systemic lupus erythematosus. Am Heart J1985; 110(6): 1257.
7.
ThulaniUBMettanandaKCDWarnakulasuriyaDTD, et al.Validation of the World Health Organization/International society of hypertension (WHO/ISH) cardiovascular risk predictions in sri Lankans based on findings from a prospective cohort study. PLoS One2021; 16(6): e0252267.
8.
KimMHAbramsGDPernicanoPG, et al.Sudden death in a 55-year-old woman with systemic lupus erythematosus. Circulation1998; 98(3): 271–275.
9.
SacreKEscoubetBPasquetB, et al.Increased arterial stiffness in systemic lupus erythematosus (SLE) patients at low risk for cardiovascular disease: a cross-sectional controlled study. PLoS One2014; 9(4): e94511.
10.
Hippisley-CoxJCouplandCBrindleP. Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease: prospective cohort study. Br Med J2017; 357: j2099.
11.
MendonçaJAde AndradeBBde AquinoJLB, et al.Spectral doppler and automated software-guided ultrasound assessment of bilateral common carotid intima-media thickness in spondyloarthritis: is there a correlation with clinical findings?Drugs Context2018; 7: 212538.
12.
D'AgostinoRBSPencinaMJMassaroJM, et al.Cardiovascular disease risk assessment: insights from Framingham. Glob Heart2013; 8(1): 11–23.
13.
MendonçaJAPansaniLNMimotoMB, et al.Nail enthesis ultrasound and automated software-guided assessment of bilateral common carotid intima-media thickness in psoriasis and psoriatic arthritis: is there a correlation with clinical and laboratory findings?Drugs Context2020; 9: 2.
14.
De RossiSDMendonçaJAPalominosPE, et al.Ultrasonographic and resistance index evaluation of nails in psoriatic arthritis, psoriasis, and control groups: a cross-sectional study. Adv Rheumatol2021; 61(1): 48.
15.
RomanMJCrowMKLockshinMD, et al.Rate and determinants of progression of atherosclerosis in systemic lupus erythematosus. Arthritis Rheum2007; 56(10): 3412.
16.
ThompsonTSutton-TyrrellKWildmanRP, et al.Progression of carotid intima-media thickness and plaque in women with systemic lupus erythematosus. Arthritis Rheum2008; 58(3): 835–842.
17.
KostopoulouMNikolopoulosDParodisI, et al.Cardiovascular disease in systemic lupus erythematosus: recent data on epidemiology, risk factors and prevention. Curr Vasc Pharmacol2020; 18(6): 549–565.
18.
ZhangWTLiuZZhuBC, et al.Effects of tobacco smoking on cardiovascular disease in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Front Immunol2022; 13: 967506.
19.
ChungCPAvalosIOeserA, et al.High prevalence of the metabolic syndrome in patients with systemic lupus erythematosus: association with disease characteristics and cardiovascular risk factors. Ann Rheum Dis2007; 66(2): 208–214.
DurcanLO'DwyerTPetriM. Management strategies and future directions for systemic lupus erythematosus in adults. Lancet2019; 393(10188): 2332.
22.
HanleyAJKarterAJFestaA, et al.Factor analysis of metabolic syndrome using directly measured insulin sensitivity: the Insulin resistance atherosclerosis study. Diabetes2002; 51(8): 2642.
23.
García-CarrascoMMendoza-PintoCMunguía-RealpozoP, et al.Insulin resistance and diabetes mellitus in patients with systemic lupus erythematosus. Endocr, Metab Immune Disord: Drug Targets2023; 23(4): 503–514.
24.
DrososGCVedderDHoubenE, et al.EULAR recommendations for cardiovascular risk management in rheumatic and musculoskeletal diseases, including systemic lupus erythematosus and antiphospholipid syndrome. Ann Rheum Dis2022; 81(6): 768–779.
